AccountId: 011433970860
ContactId: 9ba8ab86-5086-46d4-ae5c-df20190d83be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192960 ms
Total Talk Time (AGENT): 99163 ms
Total Talk Time (CUSTOMER): 55416 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/9ba8ab86-5086-46d4-ae5c-df20190d83be_20250114T20:47_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, good afternoon, my name is [PII]. I'm calling from a specialist office. I need the eligibility and benefits for one of our patients.
[AGENT][NEUTRAL] OK, sure. I can assist you with benefits and eligibility, and you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEGATIVE] Hold on, I think I lost her.
[CUSTOMER][NEUTRAL] Policy number is 01638489ML8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you said this is for an office, correct?
[CUSTOMER][NEUTRAL] Yes, specialist office.
[AGENT][NEUTRAL] OK. All right, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical. This particular policy covers the office procedures or office treatment. It will not cover the office visit.
[AGENT][NEUTRAL] The office treatment procedures are subject to the outpatient maximum, which is $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it doesn't cover the office visit, but it covers the treatments and procedures and stuff like that.
[AGENT][NEUTRAL] Hm
[AGENT][POSITIVE] Procedures. Yes, correct. Mhm. Yes.
[CUSTOMER][NEUTRAL] OK, and it's 500 per day?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Can I get a reference phone number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] OK, sure. That's [PII].
[CUSTOMER][NEUTRAL] Does she so she doesn't have any deductibles or maxed out of pocket?
[AGENT][NEUTRAL] Um, with us, no, there's no deductibles, co-payment and co-insurance. We are the secondary, so we help with the deductibles, co-payment and co-insurance from the major medical, but only for procedures, not for the visit. OK? Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you very much though.
[AGENT][NEUTRAL] Really?
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] Um, just in case
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.